| National Provider Identifier [NPI]: | 1922004159 |
| Last Name Of The Provider | MARTIN |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MS CFNP |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11541 KINGSTON PIKE |
| Street Address 2 Of The Provider | STE 101 |
| City Of The Provider | KNOXVILLE |
| Zip Code Of The Provider | 379340000 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 597 |
| Number Of Medicare Beneficiaries | 53 |
| Total Submitted Charge Amount | 29181.1 |
| Total Medicare Allowed Amount | 22503.41 |
| Total Medicare Payment Amount | 16084.12 |
| Total Medicare Standardized Payment Amount | 20233.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 59 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 2090 |
| Total Drug Medicare AllowedAmount | 917.28 |
| Total Drug Medicare PaymentAmount | 862.9 |
| Total Drug Medicare Standardized Payment Amount | 862.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 538 |
| Number Of Medicare Beneficiaries With Medical Services | 53 |
| Total Medical Submitted Charge Amount | 27091.1 |
| Total Medical Medicare Allowed Amount | 21586.13 |
| Total Medical Medicare Payment Amount | 15221.22 |
| Total Medical Medicare Standardized Payment Amount | 19370.92 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 28 |
| Number Of Male Beneficiaries | 25 |
| Number Of Non Hispanic White Beneficiaries | 33 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 19 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | 0 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 1.2171 |